Current extensive research on aerobic granular sludge (AGS) largely focuses on improving its microbial biodiversity, settlement behavior, nitrogen and phosphorus removal efficiency, and shock load resistance. Great challenges that have to be faced are the bottleneck of slow-speed granulation and easy disintegration after granulation, which are key to the extended application of AGS technology. In the present review, the typical morphological structures of AGS are firstly summarized as well as the granulation model hypotheses, and then, we analyze the dominant microflora and their spatial distribution features. The influencing factors on particle structure stability are discussed thereafter on a macro and micro scale. Prospects and future research trends are also discussed based on the current study results for AGS technology.